ID H0419

Medicaid eligibility expansion for adults under 65 with income at or below 133% of federal poverty level is prohibited until July 1, 2025, unless nine conditions are met.

Required conditions include maintaining 90% federal financial participation, implementing work requirements of 20+ hours per week with specific exemptions for minors, disabled individuals, pregnant women, and caregivers, and establishing an enrollment cap of 50,000 persons or the number of disabled/elderly Medicaid enrollees, whichever is lower.

Additional conditions require a 5% or less improper payment rate, suspension of automatic renewal processes, a 36-month lifetime benefit limit, biannual redetermination for expansion enrollees, and limitation of presumptive eligibility to children and pregnant women.

Department must submit state plan amendments or waiver requests by July 1, 2024, notify legislature within 30 days of any federal action, and terminate expansion eligibility by October 1, 2025, if conditions are not met by July 1, 2025, or within 90 days if conditions cease to be met thereafter.

Prohibits Medicaid funds for gender reassignment procedures for adults over 18 and for services prohibited under Idaho Code section 18-1506C; act becomes effective July 1, 2024, with emergency declaration.